State Refugee Health Programs

Refugee Health Programs are vital to the refugee resettlement program and the national public health system. They universally strive to protect public health and the well-being of refugees resettled in the U.S. Refugee Health Programs are funded by federal, state and local resources, and support the CDC public health mission among refugee populations. Refugee Health Programs are currently found in the District of Columbia and all states except Wyoming. As the representative organization for Refugee Health Coordinators, ARHC’s activities are based on, and intimately tied to, the goals and activities of public health, including:

Linkage with Health Care Services and Care Coordination. Refugee Health Programs ensure oversight of, and access to, domestic health assessments, immunization services, health education and other resources for refugees’ immediate and ongoing health needs. As the domestic counterpart to the overseas medical examination processes, Refugee Health Programs’ health assessment services provide early access to the U.S. health care system and support for refugees’ self-sufficiency and long-term well-being. Although refugee resettlement agencies maintain a responsibility to ensure that refugees access appropriate services, they often rely on Refugee Health Programs to assist with appropriate medical care coordination and referral services.

Assessment and Immunizations for Asylees, Cuban and Haitian Entrants, and Victims of Trafficking. Refugee Health Programs help ensure domestic health assessment, immunization, and referral services to populations that, like refugees, are eligible for federal refugee services and benefits but often have not had an overseas medical examination due to the nature of their resettlement. These include asylees, Cuban and Haitian entrants, certain victims of trafficking, and Iraqi and Afghan special immigrants. Refugee Health Programs will assist relevant agencies to provide accessible, timely services to these populations in order to protect public health.

Health Education. Health education is vital to the health and well-being of the refugee population. While refugees may receive some health education, overseas or upon resettlement, information is limited. Due to the complex structure of healthcare services and benefits in the U.S., Refugee Health Programs often help provide health education for the refugee population that extends beyond standard prevention and education messages to include healthcare system education.

Reducing Health Disparities. Refugees are vulnerable populations due to their personal histories, and often suffer disproportionately from health disparities, especially in the areas of physical trauma and mental health. Refugee health needs are complex and often on going; there is a constant need for quality domestic health services that are culturally and linguistically appropriate. Refugee Health Programs help provide this critically needed health care by: 1) understanding the cultural, historical, and traumatic experiences of refugees and their effects on health status and health care utilization; 2) gathering and using refugee health data to improve services and inform policy; and 3) including refugee communities in addressing refugees’ health disparities.

Refugee Health Programs vary widely from state to state, both administratively and programmatically. Many programs are administered by the state’s Department of Health/Public Health. Programs may delegate health screenings to public clinics such as local health departments and some public community health centers. Programs may contract with private providers and private community health centers. Other programs may consist of public-private provider partnerships to provide refugee health services. In some states, the refugee health program may be administered through a Wilson-Fish Alternative Project. There are even states that have mixtures of these types of partnerships depending on the city/region within their state and what services/resources are available. Throughout the country screenings/assessments are occurring at community health centers/Federally-Qualified Health Centers (FQHCs), county/local health departments, private practices, stand-alone clinics, and hospital/university based clinics.